Clinical features of critically ill patients infected with SARS-CoV-2 outside Wuhan with and without diabetes
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ORIGINAL ARTICLE
Clinical features of critically ill patients infected with SARS-CoV-2 outside Wuhan with and without diabetes Xiaojuan Peng 1 & Yanfang Chen 2 & Liangfei Deng 3 & Qi Liu 4 & Qing Li 5 & Jie Xiong 4 & Ying Shi 2 & Shaohui Tang 2 Received: 24 August 2020 / Accepted: 21 October 2020 # Research Society for Study of Diabetes in India 2020
Abstract Aim Some patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rapidly develop to critical condition. Here, we investigated the clinical features of critically ill SARS-CoV-2 patients with and without diabetes and identified risk factors for death of these patients. Methods The medical records including epidemiological, demographic, clinical, and laboratory data from 49 critically ill SARSCoV-2 patients were collected and analyzed in Huanggang City and Xiaogan City, Hubei Province, outside Wuhan. Results Sixty-seven percent (33) of patients survived and 33% (16) of patients died in 49 critically ill patients (32 men, 17 women), with a median age of 63 years (IQR 53–73). Univariate analyses indicated that the deceased patients were more often associated with two or more comorbidities, one or more gastrointestinal symptoms, high neutrophil percentage, low lymphocytes and lymphocyte percentage, high C-reactive protein, high procalcitonin, high fasting blood glucose (FBG), and high lactate dehydrogenase (LDH) compared with the survivors; moreover, the patients with T2DM had the higher neutrophil percentage, the lower lymphocyte percentage, and the higher levels of FBG and LDH compared with the patients without T2DM. Multivariable logistic regression analyses indicated that gastrointestinal symptoms (≥ 1 symptoms), decreased lymphocytes (< 1.1 × 109/L), and increased FBG (≥ 7.0 mmol/L) were the independent risk factors for death of critically ill patients. Conclusions Critically ill COVID patients with T2DM had more severe damages of the lymphocytes, islet cells, and heart function, and gastrointestinal symptoms, lymphopenia, and increased FBG may be early predictors for poor prognosis. Keywords SARS-CoV-2 . Critically ill patients . Clinical features . T2DM . Independent risk factors
Introduction Coronaviruses (CoVs) are enveloped, positive-sense, singlestranded RNA viruses and belong to the family Coronaviridae
and the order Nidovirales, of which two coronaviruses, severe acute respiratory syndrome coronavirus (SARS-CoV) [1, 2] and Middle East respiratory syndrome coronavirus (MERSCoV) [3], have caused recent pandemics of respiratory
Xiaojuan Peng, Yanfang Chen, Liangfei Deng, Qi Liu and Qing Li contributed equally to this work. Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s13410-02000888-3. * Shaohui Tang [email protected]
3
Department of Critical Medicine, Affiliated Hospital (Clinical College) of Xiangnan University, Chenzhou 423000, Hunan, People’s Republic of China
1
Department of Endocrinology, Affiliated Hospital (Clinical College) of Xiangnan
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